Provider Demographics
NPI:1760832448
Name:CEARLEY, LINDA
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:CEARLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2606 WYATT DR
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97501-1105
Mailing Address - Country:US
Mailing Address - Phone:509-820-1598
Mailing Address - Fax:
Practice Address - Street 1:503 AIRPORT RD STE 101
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-4159
Practice Address - Country:US
Practice Address - Phone:541-200-2900
Practice Address - Fax:541-200-2948
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-14
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health